CMS Price Transparency Data

Blood test, potassium

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $53
Cash Discount Price: $67
vs. Medicare Baseline: 11.13x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at UPMC Children's Hospital of Pittsburgh is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 11.13x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)

Cash / Self-Pay: $67 (1408%)

Insurance Median: $53 (1113%)

Cash: $67 (1408% of Medicare)

Ins. Median: $53 (1113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1113% of the Medicare baseline (a markup of 1013%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$4 - $62	84%
Amerihealth Caritas	$5 - $24	105%
Blue Cross Blue Shield	$5 - $38	105%
Cigna	$5 - $62	105%
Health Plan Of Upper Ohio Valley	$5 - $73	105%
Upmc Health Plan	$15 - $20	315%
Health Partners Plans (Jefferson Health Plan)	$25	525%
UnitedHealthcare	$25 - $53	525%
Geisinger	$26 - $50	546%
Highmark Wholecare (Prev Gateway)	$26	546%
Pa Health & Wellness	$26	546%
Intergroup	$73 - $95	1534%
Coventry/First Health	$90	1891%
Saudi Armed Forces	$90	1891%
Health Payors Organization	$95	1996%
Multiplan	$95	1996%
National Provider Network	$101	2122%
Private Health Care Systems	$101	2122%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $67.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84132.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Children's Hospital of Pittsburgh is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84132.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.